<p>Malnutrition, Airflow Limitation and Severe Emphysema are Risks for Exacerbation of Chronic Obstructive Pulmonary Disease in Japanese Subjects: A Retrospective Single-Center Study</p>

Abstract

Background: Different characteristics of patients with chronic obstructive pulmonary disease (COPD) between Western and Japanese populations have been reported. Risk factors for COPD exacerbation have been reported in Western countries but have not been studied in Japan. Patients and Methods: We retrospectively examined risk factors for COPD exacerbation. A total of 156 Japanese patients were enrolled, and the records of 136 patients were analyzed. Results: In the exacerbation group (n=60), body mass index, forced vital capacity (FVC), forced expiratory volume in one second (FEV 1), the FEV 1 /FVC ratio (FEV 1 /FVC), the percent predicted values of FEV 1 (%FEV 1), and serum total protein (TP) and albumin concentrations were lower, and age, mortality rate, frequency of common cold and pneumonia, COPD severity rankings, modified Medical Research Council (mMRC) dyspnea score, and proportions of patients with severe emphysema (>50% of low attenuation area) and receiving long-term oxygen therapy were higher than those in the nonexacerbation group (n=76). However, the proportion of patients with a greater number of eosinophils (≥200/μL and/or ≥2%) and the exhaled nitric oxide concentration did not differ between the two groups. In the univariate analysis, the risk factors for exacerbation were age; long-term oxygen therapy; low FVC, FEV 1 , FEV 1 /FVC and %FEV 1 ; high COPD severity ranking and mMRC score; severe emphysema; hypoproteinemia (<6.5 g/ dL); hypoalbuminemia (<3.5 g/dL); leukocytosis; lymphocytopenia; and anemia. In the multivariate analysis, the risk factors were hypoalbuminemia, hypoproteinemia and low FEV 1. Additionally, in patients in the exacerbation-induced mortality subgroup, age, exacerbation frequency, mMRC score and the proportion of patients with lymphocytopenia were higher, and FVC, %FVC, FEV 1 , serum TP concentration and the lymphocyte number were lower than those in the exacerbation survival subgroup. Conclusion: Malnutrition, airflow limitation and severe emphysema were risks for exacerbation and mortality associated with infection in Japanese patients with COPD.

Association between Malnutrition and Quality of Life in Elderly Patients with Rheumatoid Arthritis

“…The adverse impact of malnutrition on morbidity, mortality and QoL in a variety of diseases has already been recognized [ 18 , 19 , 20 ]. The available publications report associations between the above-mentioned disorders typical for the elderly population and malnutrition in patients with cardiovascular disease [ 18 ], respiratory disorders [ 19 ], or cancers [ 20 ], but few papers have been published on patients with rheumatic diseases. Therefore, we have undertaken to evaluate nutritional status, cognitive impairment, functional limitations, frailty syndrome severity, and their associations with QoL.…”

Effect of low protein intake on acute exacerbations in mild to moderate chronic obstructive pulmonary disease: data from the 2007–2012 KNHANES

“…A previous prospective study demonstrated that patients with a lower BMI or those who had a weight reduction during the previous year had an increased likelihood of having an exacerbation compared with patients whose weight was either unchanged or increased (26). In addition, there are reports that hypoalbuminemia and hypoproteinemia are independent risk factors of exacerbation (27,28). We could not find any data on the levels of protein, albumin, prealbumin, and retinol-binding protein, which have been considered as markers of visceral protein stores.…”

The Clinical Characteristics of Intestinal Flora Imbalance in Stable Chronic Obstructive Pulmonary Disease (COPD) and Construction of Early Warning Model

“…Among them, CCI score > 2 and GSRs score > 2 increased the risk of intestinal ora disorders in stable COPD patients by 25.633 times and 17.113 times, respectively, whereas BMI > 23.25kg/m 2 and ALB > 32.5g/L might be protective factors, which decreased the risk of intestinal ora disorders in stable COPD patients by 0.090 times and 0.278 times, respectively. BMI is often regarded as indicator of the body's nutritional status and reports also demonstrated the association of low BMI with exacerbation in patients with COPD [11]. A 3-year South Korean study of follow-up BMI to predict the prognosis of COPD found that the decrease in BMI was independently related to the deterioration of COPD and the increase of mortality (HR = 3.167) [12].…”